Motivation and emotion/Book/2022/Antidepressants and motivation

Antidepressants and motivation:
What are the effects of popular antidepressants on motivation?

Multimedia presentation (3 min)

Overview

Fig 1: Antidepressant drugs are available in a variety of oral tablet forms.

Motivation's Latin origin means "to move," and psychologists that specialise in motivational psychology basically research what causes people to act and why they think and behave the way they do. We concentrate on people's decisions on the activities they do, their pursuit of those tasks with perseverance and intensity, their level of involvement throughout those tasks, and their perceptions of their performance and objectives in line with this comprehensive perspective of motivation (Eccles et.al., 1998). A person's motivation is the reason(s) they act or behave in a particular way. A person's motivation often fuels their drive to perform something. This is a key component in achieving one's life objectives. These objectives may be societal, personal, or competitive.

Depression and other mental diseases might develop as a result of a lack of drive. Almost all facets of human conduct depend on motivation. Your motivational condition undoubtedly affects your decision-making process. However, these theories have nothing to do with the ones studied in social psychology or organisational psychology. Additionally, cognitive/affective neuroscience has fundamentally distinct definitions and theories of motivation. (Simon, 1994). There are two different motivation theories put out by psychologists. The two categories of motivation in dualistic theories are intrinsic and extrinsic. Contrarily, multifaceted theories acknowledge a variety of genetically unique motivations. Construction validity, measurement dependability, and experimental control are at least three areas where intrinsic-extrinsic dualism falls short. (Reiss, S. 2012) The most popular definition of intrinsic drive is "doing something for its own sake," as in a young toddler playing baseball solely out of desire. Contrarily, extrinsic motivation refers to the pursuit of an instrumental aim, such as when a young child plays baseball to win over a parent or a competition. The self-determination hypothesis of Deci and Ryan (1985) contends that extrinsic rewards conflict with intrinsic motivation. Let's say a young man who enjoys baseball for its own reason is given the chance to earn money. Self-determination theory contends that the boy's intrinsic pleasure of baseball is compromised by extrinsic incentives (such as money and success). Without external motivation, the youngster is likely to play baseball less in the future.

Major depressive illness, some anxiety disorders, some chronic pain problems, and some addictions are all treated with antidepressants, a family of drugs. Dry mouth, weight gain, headaches, dizziness, sexual dysfunction, and emotional blunting are typical adverse effects of antidepressants. When children, teenagers, and young adults use these medications, there is a modest increase in the risk of suicidal thoughts and actions. Any antidepressant can cause a withdrawal syndrome after ceasing use, which mimics recurrent depression. Selective serotonin reuptake inhibitors (SSRIs), which are frequently prescribed to treat depression, are linked to apathy, which is a combination of apathy, anorexia, and a lack of motivation. (Padala et.al., 2020)

Focus questions: How do antidepressants function? How do antidepressants generally affect people? Which elements of motivation are affected by antidepressants?

The relationship between motivation and antidepressants

Consuming antidepressants like selective serotonin reuptake inhibitors (SSRI) has occasionally been linked to emotional blunting as well as behavioural indifference. In both psychiatric and general care settings, selective serotonin reuptake inhibitors (SSRIs) have become widely used as pharmaceutical therapies for a variety of mental problems. These medications' broad clinical effectiveness, which is perfect in clinical cases with mental comorbidity, and their comparatively low side effects are likely to be to blamed for their unparalleled degree of acceptance (with the exception of sexual dysfunction). However, behavioural and emotional indifference may be linked to another unfavourable clinical side effect of SSRIs. The clinical trait of apathy or poor motivation as a behavioral condition has been highlighted in relation to SSRI medication. It appears that some people are aware of this potential adverse effect.(Sansone et.al., 2010)

In a research by (Fava et al., 2006) which included participants from both the United States and Italy, almost one-third of antidepressant users expressed apathy, with 7.7% of those reporting moderate-to-severe impairment, and nearly 40% admitted a loss of motivation, with 12.0% indicating such impairment.

Motivation

Incentive Theory

A behavioural theory called the incentive theory of motivation contends that people are driven by a desire for rewards and reinforcement. The incentive theory also suggests that people avoid behaviours that can result in punishment and behave in ways they think will lead to rewards. Incentive theory started to develop in the 1940s and 1950s. The incentive hypothesis contends that people are drawn toward behaviours that result in rewards and driven away from acts that can result in adverse effects, rather than emphasising more internal causes driving motivation. There are many distinct circumstances in which the prospect of reward or punishment directly affects conduct. Perhaps preparing for a test to achieve a good mark, competing in a marathon to be recognised, or taking on a new role at work to get promoted are some examples. An incentive to get something in exchange for efforts affected each of these acts. According to incentive theory, behavior is driven by an organism's need for reinforcements and rewards, which also controls behavior. The environment's incentives control how creatures behave. In that it emphasises how much the environment affects conduct, this theory is a behaviorist one. If the results of an action are favorable, an organism is more likely to continue that activity. If a behavior has negative effects, an organism is less likely to repeat it. Environment-based factors act as driving forces behind motivation. An organism is more likely to continue engaging in actions that result in these rewards in the future when there are reinforcements present, such as food and money.(Incentive Theory. n.d.)

Case Study: According to an experiment from (Logan, 1968) Since incentive motivation is simply one of several conceptual factors that influence instrumental performance, it cannot be directly measured. However, it is anticipated that selecting between two otherwise comparable options can be used to index their respective incentive values. In the chapter, a choice method using rats as test subjects was used to experimentally analyse the pace at which incentive motivation shifts in response to a change in the reward circumstances. It is reasonable to make the premise that incentive motivational change rates are constant. An appropriate change happens at a rate that is more or less independent of previous experimental history when the incentive value of the reward received after a response changes from the preexisting incentive motivation for that response.

Fig 3: Competence Theory

Competence Theory:

Competence motivation theory is a conceptual framework created to explain why people are motivated to take part, stick with something, and put in a lot of effort in any given situation for accomplishment. The main tenet of the idea is that people are drawn to engaging in things they feel competent or skilled at. (Horn, 2014)

Antidepressants

Chemical components of antidepressants

Fig 4: Chemical components of antidepressants

According to (Griffin, 2009)Numerous researchers think that the way in which antidepressants influence certain brain circuits and the substances (referred to as neurotransmitters) that transport signals from one nerve cell to another in the brain accounts for their therapeutic effects. These substances consist of norepinephrine, dopamine, and serotonin. Distinct antidepressants appear to have different effects on these neurotransmitters' behaviours. The main categories of antidepressants are listed below. In research from (Andrade & Kumar Rao, 2010) suggests that stress and depression cause the hippocampus and prefrontal cortex to lose synapses, dendritic spines, and dendritic atrophy; glial cells also shrink in size and number. As a result, the nucleus accumbens, the hypothalamus, and the prefrontal cortex as well as downstream structures like the hippocampi and the prefrontal cortex all operate improperly. Antidepressant medications are linked to the stimulation of neurogenesis, gliogenesis, dendritic arborization, and the development of new synapses in areas including the hippocampus and prefrontal cortex.Because these modifications reverse the neurohistological effects of stress and may enable the relearning of healthier cognitions, healthier emotional reactions, and healthier behavioural expressions, they may be the mechanisms underlying the antidepressant response because their time course of development parallels that of antidepressant action.

Treatment

Our brain's nerve cells transmit information via a variety of substances. Although there are still many unanswered questions, researchers believe that depression is brought on by an imbalance of certain chemical messengers (neurotransmitters), such as serotonin, which prevents appropriate signal transmission along the neurons. The goal of antidepressants is to make these substances more readily available. Different medications accomplish this in different ways. Most people take antidepressants every day. In the initial weeks and months, the objective is to reduce the symptoms and, where feasible, make the depression disappear. After achieving that, the course of therapy is maintained for at least four to nine months. To prevent the symptoms from reappearing, this further therapy is required. In order to avoid relapses, the medicine may occasionally be used for longer. The length of therapy also relies on the progression of the symptoms over time and the likelihood of relapse. Some people use antidepressants for a long period of time. The dose is progressively decreased over a number of weeks toward the conclusion of the treatment. When stopping antidepressants, transient sleep issues, nausea, or restlessness may occur. In particular, if you abruptly quit using antidepressants, these symptoms are probable. When patients start feeling better, they occasionally stop taking their medicine, although doing so raises the likelihood that their depression will return. Antidepressants don't lead to physical dependency or addiction, unlike many sedatives and sleeping medications.

How well can antidepressants prevent relapses?

To avoid relapses, antidepressants are often used for one to two years, and occasionally longer. Relapse prevention might be beneficial for those who

• have a history of relapses
• are determined to prevent a relapse,
• or suffer from persistent depression.

Taking frequently prescribed antidepressants like TCAs, SSRIs, or SNRIs can reduce the chance of relapses but cannot totally avoid them, according to studies on adults:

• Without preventative care: Of 100 persons who received a placebo, almost 50 experienced a recurrence within one to two years.
• When receiving preventative care, 23 out of every 100 persons who took an antidepressant experienced a relapse within a year to two years.
• To put it another way, long-term antidepressant use effectively avoided a relapse in an average of 27 out of 100 people

Uses of antidepressants and their effects on the human body

Types of antidepressants

There are several antidepressants available to treat mental illness. They can be divided into many groups. The major focus of this chapter is on the most popular antidepressants:

Antidepressants in various forms.

tricyclic mood stabilizers (TCAs)

inhibitors of the selective serotonin reuptake (SSRIs)

inhibitors of the selective serotonin and noradrenaline reuptake (SNRIs)

The most time has been spent on the market for tricyclic antidepressants. They are regarded as antidepressants of the first generation. The second generation of antidepressants includes SSRIs and SNRIs.

Less frequently administered medications include:

antagonists of the adrenergic alpha-2 receptor

Inhibitors of monoamine oxidase (MAO)

Selective inhibitors of noradrenaline reuptake

Selective inhibitors of noradrenaline and dopamine reuptake

Serotonin 5-HT2C receptor antagonists and melatonin receptor agonists

Side effects on the human body

Side effects are possible with antidepressants. The majority of persons who use antidepressants have adverse effects. They often happen in the first several weeks of therapy and become less frequent as time goes on. Some of these adverse effects, which are common to many medications in the same class, are thought to be a direct result of the drug's impact on the brain. Dry mouth, headaches, vertigo, restlessness, and sexual issues are a few examples. These issues are frequently thought to be pharmaceutical adverse effects. However, some of these could be brought on by sadness itself.

Some adverse effects are more frequent with specific medications:

Tricyclic antidepressants are less likely to induce diarrhoea, headaches, sleep issues, or nausea than SSRIs are.

Tricyclic antidepressants are more likely than SSRIs to result in visual issues, constipation, dizziness, a dry mouth, shaking, and trouble urinating (peeing).

Tricyclic antidepressants frequently have more negative side effects than SSRIs and SNRIs. Because of this, more individuals tend to cease using tricyclic antidepressants: Research has shown that around 15 out of 100 individuals using tricyclic antidepressants stopped doing so, compared to approximately 10 out of 100 those taking SSRIs. If tricyclic antidepressants are used in excess, there is also a higher chance of experiencing severe adverse effects.

Severe Side effects

Antidepressants might make you feel lightheaded and unsteady, which raises your chance of falling and breaking a bone, especially if you're older. This risk may rise as a result of drug interactions. Very few people have experienced liver damage, cardiac issues, or epileptic seizures while using antidepressants. These antidepressant side effects are thought to be uncommon. According to several research, adolescents who use SSRIs or SNRIs are more likely to consider killing themselves (suicide) and are more likely to make suicide attempts. Teenagers should visit their doctor or therapist more frequently at the start of treatment as a result, allowing for the early detection of any suicide risk.

Quizzes

Here are some simple quiz questions. Choose the correct answers and click "Submit":

1 1. If someone has intrinsic motivation to go for a jog every evening, she is most likely to jog for which reason?:

	She likes the way she feels when she jogs
	She wants to please her mother by losing some weight

2 2. What influences set points for body weight?:

	Basal metabolic rate
	Energy output
	All of the above

Conclusion

Popular antidepressants affect human motivation in a variety of ways. Many motivation theories shed light on the parts of human wants that generate motivation in a human. Antidepressants can also increase your energy and motivation, which may be very low when you are depressed. Before your feelings of hopelessness have started to fade, you may have increased energy and inspiration early on in your treatment. Treatment for apathy and a lack of motivation can be challenging. Numerous medications that help with various depressive side effects don't work well for these issues. Depression is known for having a persistent lack of motivation. Additionally, discouragement might destroy when a person experiences a decreased desire to finish particular tasks or take part in routine activities. The clinical faculty acknowledges that a decline in Template:What? affects the balance of synapses or synthetic substances that regulate thought in the brain. Clinical medications can aid in regulating synapses, which may help depressed people think more clearly and motivate themselves better. Particular serotonin reuptake inhibitor openness has occasionally been linked to both social carelessness and diminished enthusiasm. These two disorders are sometimes portrayed as distinct entities, although they may really be combined under the single term "selective serotonin reuptake inhibitor-induced indifference" because they are both characterised by apathy.

See also

• Antidepressants (Wikipedia)
• Incentive Theory (APA Journal)
• Competence Theory(Journal Article)
• Affiliation Motivation (Book chapter, 2013)

References

Andrade, C., & Kumar Rao, N. S. (2010). How antidepressant drugs act: A primer on neuroplasticity as the eventual mediator of antidepressant efficacy. Indian Journal of Psychiatry, 52(4), 378-386. https://doi.org/10.4103/0019-5545.74318

Antidepressant. (2022, October 17). In Wikipedia. https://en.wikipedia.org/wiki/Antidepressant

Antidepressant. (2022, October 17). In Wikipedia. https://en.wikipedia.org/wiki/Antidepressant

Benabou, & Tirole, J. (2003). Intrinsic and Extrinsic Motivation. The Review of Economic Studies, 70(3), 489–520. https://doi.org/10.1111/1467-937X.00253 Deci, E. L., & Ryan, R. M. (1985). Motivation and self-determination in human behavior. NY: Plenum Publishing Co.

Eccles, J. S., Wigfield, A., & Schiefele, U. (1998). Motivation to succeed.

Fava, M., Graves, L. M., Benazzi, F., Scalia, M. J., Iosifescu, D. V., Alpert, J. E., & Papakostas, G. I. (2006). A cross-sectional study of the prevalence of cognitive and physical symptoms during long-term antidepressant treatment. Journal of Clinical Psychiatry, 67(11), 1754-1759.

Griffin, M. R. (2009, November 5). How Different Antidepressants Work. WebMD. Retrieved October 18, 2022, from https://www.webmd.com/depression/how-different-antidepressants-work

Herzberg, F. (2017). Motivation to work. Routledge.

Horn, T. (2014). Competence motivation theory. In R. Eklund, & G. Tenenbaum (Eds.), Encyclopedia of sport and exercise psychology (pp. 155-158). SAGE Publications, Inc., https://dx.doi.org/10.4135/9781483332222.n70

Incentive Theory. (n.d.). In Alleydog.com's online glossary. Retrieved from: https://www.alleydog.com/glossary/definition-cit.php?term=Incentive+Theory Logan, F. A. (1968).

Incentive Theory and Changes in Reward. Psychology of Learning and Motivation, 2, 1-30. https://doi.org/10.1016/S0079-7421(08)60420-X Padala, Padala, K. P., Majagi, A. S., Garner, K. K., Dennis, R. A., & Sullivan, D. H. (2020).

Reiss, S. (2012). Intrinsic and Extrinsic Motivation. Teaching of Psychology. https://doi.org/10.1177/0098628312437704

Sansone, R. A., & Sansone, L. A. (2010). SSRI-Induced Indifference. Psychiatry (Edgmont (Pa. : Township)), 7(10), 14–18.

Selective serotonin reuptake inhibitors-associated apathy syndrome: A cross sectional study. Medicine (Baltimore), 99(33), e21497–. https://doi.org/10.1097/MD.0000000000021497

Simon, H.A. (1994). The bottleneck of attention: Connecting thought with motivation. In W. D. Spaulding (Ed.), Nebraska symposium on motivation, Vol. 41. Integrative views of motivation, cognition, and emotion. (pp. 1-21): Lincoln, Nebraska, U.S.: University of Nebraska Press.

External links

• Blood Test for Depression (Way Ahead NSW)
• SSRI and SNRI Antidepressants(Headspace AU)
• Crisis Support (Lifeline AU)
• Relationship between Antidepressants and Motivation